Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle P Shaffer, DPT

Individual provider Physical Therapist · NPI 1720336894

Kyle P Shaffer, DPT is a Physical Therapist in Private Practice in Marion, Indiana. Qualified in 2012, 14 years ago. Practices with Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PA, a 385-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
14
Licensed in
IN
In the registry since
2012
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4725 S Colonial Oaks Dr
Marion, IN 46953-5341
Phone: (765) 674-9791
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 05010977A (IN)
Physical Therapist Taxonomy 225100000X · Licence 99053331A (IN)

Record details

NPI number1720336894
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedAugust 21, 2012
Last updated in NPPESMay 4, 2023
Certification dateMay 4, 2023
Mailing address1311 Mamaroneck Ave Ste 140, White Plains, NY 10605-5224

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Ivyrehab Physical Therapy, Occupational Therapy And Speech Language Pa — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Marion